The validity of self-rated psychotic symptoms in depressed inpatients ☆

Abstract Background Self-ratings of psychotic experiences might be biased by depressive symptoms. Method Data from a large naturalistic multicentre trial on depressed inpatients ( n  = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Asberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale. Results At discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P P P P P P P P  = 0.02). Conclusions In depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.